HomeAnswersMedical oncologycancer immunotherapyMy dad has metastatic NSCLC lung cancer. What is the treatment?

Will immunotherapy for metastasized NSCLC lung cancer for a few months give some benefit instead of no immunotherapy?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At January 6, 2023
Reviewed AtOctober 9, 2023

Patient's Query

Hi doctor,

My father was diagnosed with metastasis NSCLC lung cancer, which spreads to the ninth and eighth ribs of the chest (all other organs are still not affected). Two cycles of chemotherapies are completed in the last one and half months with 21 days intervals. Now the doctor suggested chemotherapy plus immunotherapy. And as per the doctor, if immunotherapy works, then it will be continued for at least two years. But immunotherapy is very expensive. We do not think we can continue for up to two years, so my question is if we continue the immunotherapy for a few months, like eight to ten months, will it give some kind of benefits compared to no immunotherapy at all?

Hi,

Welcome to icliniq.com.

I have gone through your query and can understand your concerns.

Usually, immunotherapy plus chemotherapy is suggested for two years as per international guidelines.

Its duration can be reduced if the PET scan shows a complete response (complete resolution of disease). Then it can be stopped earlier. Also, there is upcoming evidence that immunotherapy at a reduced dose provides similar benefits as a full dose, which can help in reducing costs.

I would like to see the reports of

1. PET (positron emission tomography) CT (computed tomography).

2. NGS (next-generation sequencing) report for molecular testing.

3. PD-L1 (immunotherapy) testing.

These reports can give me an idea about the exact nature and type of lung cancer your father has.

I would be happy to help you further if you have any other questions regarding the same.

Thank you.

Patient's Query

Hi doctor,

Thanks for your reply.

Here is the molecular testing report, and as discussed with the doctor before PD-L1 score is less than 1 %. He told me as there is no targetable mutation, in this case, immunotherapy is a good option. So doctor suggested chemotherapy (Pemetrexed and Carboplatin) with immunotherapy. I have the HRCT (high-resolution computed tomography) thorax report with me. I do not think any PET scan has been performed. I will double-check. For the moment, I have these reports.

Hi,

Welcome back to icliniq.com.

1. NGS does not show any targetable mutations. In that case, immunotherapy plus chemotherapy becomes the best option.

2. Immunotherapy is generally effective if PD-L1 is positive. Need to see that report before confirming.

Reduced dose immunotherapy has shown similar efficacy in a subset of lung cancer as well as other cancers. You can discuss this with your oncologist regarding this option. Also, I would suggest getting systemic imaging done. Ideally, PET CT or CECT (contrast-enhanced computed tomography), chest, abdomen, and head to see if the disease has spread beyond the thorax.

Hope this helps.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Pawar Satyajit Jalinder
Dr. Pawar Satyajit Jalinder

Medical oncology

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